The Charcot Foot in Diabetes

Rogers, Lee C.; Frykberg, Robert G.; Armstrong, David G.; Boulton, Andrew J.M.; Edmonds, Michael; Van, Georges Ha; Hartemann, A.; Game, Frances; Jeffcoate, William; Jirkovská, Alexandra; Jude, Edward B.; Morbach, Stephan; Morrison, William B.; Pinzur, Michael S.; Pitocco, Dario; Sanders, Lee J.; Wukich, Dane K.; Uccioli, Luigi

doi:10.2337/dc11-0844

Cited by 474 publications

(569 citation statements)

References 70 publications

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“…D iabetes mellitus is the main cause of Charcot neuroarthropathy (CN) (1) and is clinically classified as follows: Charcot foot (CF), acute Charcot foot (ACF) when there is inflammation, and inactive Charcot foot when inflammatory signs are absent (2).…”

Section: Introductionmentioning

confidence: 99%

Risk factors for Charcot foot

Nóbrega

Aras

Netto

et al. 2015

Arch. Endocrinol. Metab.

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Objective: Diabetes mellitus is the main cause of Charcot neuroarthropathy and is clinically classified as follows: Charcot foot, acute Charcot foot (ACF) when there is inflammation, and inactive Charcot foot when inflammatory signs are absent. The aim of this study was to identify the risk factors for ACF in patients with type 2 diabetes mellitus. Materials and methods: A matched case-control study was conducted to assess the factors associated with acute Charcot foot from February 2000 until September 2012. Four controls for each case were selected 47 cases of ACF and 188 controls without ACF were included. Cases and controls were matched by year of initialization of treatment. Conditional logistic regression was used to estimate matched odds ratios (ORs) and 95% confidence intervals (95% CIs). Results: In multivariate analysis, patients having less than 55 years of age (adjusted OR = 4.10, 95% CI = 1.69 -9.94), literate education age (adjusted OR = 3.73, 95% CI = 1.40 -9.92), living alone (adjusted OR = 5.84, 95% CI = 1.49 -22.86), previous ulceration (adjusted OR = 4.84, 95% CI = 1.62 -14.51) were at increased risk of ACF. However, peripheral arterial disease (adjusted OR = 0.16, 95% CI = 0.05 -0.52) of 6.25 (1.92 -20.0) was a protective factor. Discussion: The results suggest that PCA in type 2 diabetes primarily affects patients under 55 who live alone, are literate, and have a prior history of ulcers, and that peripheral arterial disease is a protective factor. Arch Endocrinol Metab.2015;59(3):226-30

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Section: Introductionmentioning

confidence: 99%

Risk factors for Charcot foot

Nóbrega

Aras

Netto

et al. 2015

Arch. Endocrinol. Metab.

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“…The impairment of the autonomic nervous system due to DM causes an increase in local blood supply and the resting blood flow is much higher than in the normal patient. The sudden increase in blood flow causes calcium to dissolve, leading to osteoclastic activity of the bone and thus damaging the bone [31]. Another theory is that the repetitive minor trauma to the insensate joints leads to fracture and disintegration [32].…”

Section: Neuroarthropathymentioning

confidence: 99%

Diabetic Foot Ulcer – Diagnosis and Management

Pai¹

2013

Clin Res Foot Ankle

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Diabetes Mellitus is known to have many complications and one of the most distressing is diabetic foot ulcer which affects 15% of people with diabetes. It puts enormous financial burden on the patient and the health care services, even though it is preventable. Diabetic foot ulcer is characterized by a classical triad of neuropathy, ischemia, and infection. Each of these has a multifactorial aetiopathogenesis. These factors are compounded by mechanical stress created by foot deformities. The most commonly used classification systems are the Wagner-Ulcer Classification system and the University of Texas Wound Classification. These classifications help to predict the outcome of this condition. Prevention of this condition is paramount to prevent long term morbidity and sometimes mortality. This can be achieved by patient self-awareness and emphasis on regular foot examinations during follow-up. Care of the diabetic foot should be multidisciplinary. Debridement, dressings and offloading are the pillars of local management. Simultaneous glycemic and infection control is also essential. Amputations are usually the treatment of last resort but occasionally can be considered early to allow for faster mobilization and rehabilitation. Causative factors like peripheral vasculopathy and neuropathy must also be appropriately treated.

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“…Was anfangs nur als Salvagelösung bei Versagen der traditionell konservativen Therapie gedacht war, hat sich mittlerweile einen festen Platz in der Gesamtkonzeption der Therapie des Charcot-Fußes erobert: der Algorithmus der American Diabetes Association weist seit 2011 differentialtherapeutisch der chirurgischen Behandlung eine wesentliche Rolle zu, die dem interdisziplinären Charakter dieser schwierig zu behandelnden Entität gerecht wird [1]. …”

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Operative Rekonstruktionsverfahren beim Charcot-Fuß

Mittlmeier

2015

Oper Orthop Traumatol

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The Charcot Foot in Diabetes

Cited by 474 publications

References 70 publications

Risk factors for Charcot foot

Risk factors for Charcot foot

Diabetic Foot Ulcer – Diagnosis and Management

Operative Rekonstruktionsverfahren beim Charcot-Fuß

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